hyperthermia (pyrexia)
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Introduction
Severe hyperthermia is a core body temperature > 40.0 C (104.0 F)
Etiology
- failure of normal thermoregulation
- hyperthermia without fever may result from
- failure to adequately dissipate body heat in a hot environment
- heat stroke, exertional & non exertional
- drug-induced hyperthermia
- failure to adequately dissipate body heat in a hot environment
- true fever may arise from numerous sources including
- infection
- inflammation
- infarction or trauma
- neoplasms
- endocrinpapthies & metabolic disorders
Pathology
- the critical thermal maximum of 42 degrees C (107.6 degrees F) above which cellular dysfunction, multiple organ failure & often death
Clinical manifestations
- altered mental status
- muscle rigidity
- rhabodomyolysis
Complications
- maternal temperature > 38.5 C increases risk of neural tube defects[3]
- acute renal failure
- liver failure
- acute respiratory distress syndrome (ARDS)
- shock
- disseminated intravascular coagulation (DIC)
- rhabdomyolysis
- electrolyte abnormalities
- aspiration pneumonia
Differential diagnosis
- heat stroke: encephalopathy & fever[3]
- malignant hyperthermia[3]
- exposure to volatile anesthetics
- rigidity of masseter, increased pCO2
- neuroleptic malignant syndrome[3]
- exposure to neuroleptics or abrupt discontinuation of Sinemet
- altered mental status, severe rigidity, tachycardia, hypertension
- no myoclonus, hyporeflexia
- serotonin syndrome[3]
- agitation, rigidity, myoclonus, hyperreflexia
Management
see specific disorder
More general terms
More specific terms
Additional terms
- heat injury; heat stress; heat illness
- hyperthyroidism
- neuroleptic malignant syndrome
- pheochromocytoma; paroxysmal hypertension; adrenal medullary paraganglioma; chromoffinoma
- temperature
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 2, 830
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 88
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Medical Knowledge Self Assessment Program (MKSAP) 11, 17. American College of Physicians, Philadelphia 1998, 2015
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ Suarez L et al, The effect of fever, febrile illness, and heat exposures on the risk of neural tube defects in a Texas-Mexico border population. Birth Defects Res A Clin Mol Teratol 70:815, 2005 PMID: https://www.ncbi.nlm.nih.gov/pubmed/15468073
- ↑ Hyperthermia-Too Hot for Your Health http://www.niapublications.org/engagepages/hyperther.asp